NURS 514: Organizational Leadership: Topic 1 DQ1
Patient-centered care stems from a collaboration between a patient and a health care team. Patient-centered care refers to care that respects the values, needs and preferences of patients, uses a biopsychosocial perspective instead of relying on the biomedical perspective and creates a strong relationship between the clinician and the patients (Millenson, Shapiro, Greenhouse & DiGioia III, 2016). Business practice points out whether an organization delivers patient-centered care. For instance, patient-centered care is manifested when doctors stop relying on diagnosis and focus on the patient’s problem. Making care patient-oriented creates trusted, personal relationships between doctors and patients. Employing tools like 24/7 online portals increase patient engagement and the use of wearable technology enables patients to track parameters like cholesterol, glucose levels, blood pressure and weight all of which enhance patients centered care. Equally, the use of strict visiting hours and visitors’ restriction negates patient-centered care. Hospitals should ensure that patients can decide who to visit and when and invite family members during rounding and shift changes (Millenson, Shapiro, Greenhouse & DiGioia III, 2016). Lastly, the use of personalized medicine is a practice that portrays patient-centered care and it helps clinicians to predict drugs that suit their patients.
Regulatory requirements have also enhanced the adoption of patient-centered care. A law that has impacted PCC is the Health Information Technology for Economic and Clinical Health Act. Under meaningful use regulatory standards, hospitals are supposed to advance the electronic engagement of patients and ensure access to an online medical record (Millenson & Berenson, 2015). The Act allows patients to contribute to their data and providers are expected to incorporate patient-generated health data in their EHR clinical information. Failure to meet the criteria attracts a penalty. The Affordable Care Act (ACA) offers initiatives like patient satisfaction, patient and family engagement, and patient experience of care all of which enhance PCC (Millenson & Berenson, 2015). For instance, organizations desiring to join the Medicare Shared Saving Program have to explain how evidence-based medicine and patient engagement will be promoted.
Reimbursement and patient-centered care are intertwined. The revenue cycle management of a hospital relies on value-based care reimbursement which creates a patient-centered healthcare setting. Reimbursement redefines performance on what is essential to patients and reduces patient suffering because it indicates how interdependent streams of quality impact its outcome (Novikov et al., 2018). It also fosters an environment that is safe for patient and care providers and promotes compassionate connected care.
Patient and Family-Centered Care Tool (Appendix A)
Good Samaritan Hospital Medical Center is a 537-bed not for profit hospital that offers both inpatient and outpatient services (GSHMC, 2020). The facility main focus is chronic disease prevention by providing nutrition and weight management services, improving cancer patient outcomes by providing a comprehensive array of educational, preventative, diagnostic and treatment services and facilitating referral to appropriate resources to help in identifying and treating mental health issues. The hospital serves a community of 850, 000 individuals who come from Suffolk County’s south shore and part of southeastern Nassau County. According to the discharge data, 15.19% of patients served are of Spanish or Hispanic origin, 84.385 are from a non-Spanish or Hispanic origin and only 0.03 are from an unknown origin. Seven percent of the patients are below the federal poverty level and at least 19% are foreign-born. The hospital has 850 physicians, 1,300 nurses and more than 2,000 support staff who are committed to providing the best diagnostic, treatment and preventative care. GSHMC aims to become the preferred healthcare system in the region.
NURS 514: Organizational Leadership: Topic 1 DQ1 – Discuss the shift to value-based health care and its impact on the roles and responsibilities of advanced registered nurses. What major evolving trends in the health care policy and delivery systems will affect your practice in the next 3-5 years, and how do you think advanced registered nurse leaders will continue to influence the direction of health care,
NURS 514: Organizational Leadership: Topic 1, DQ2
From your experience, how can developing strong interprofessional relationships increase collaboration and benefit patient outcomes or organizational initiatives into today’s dynamic health care environment? What are some ways you can form an interprofessional team and collaborate with other advanced registered nurse roles in support of organizational initiatives or improved patient outcomes? Make sure to incorporate the Interprofessional Education Collaborative (IPEC) competencies in your response. NURS 514: Organizational Leadership Discussions and Essay Assignment.
Re: Topic 2 DQ 2
What differentiates servant leadership from other styles of leadership is the primary focus on the follower first. Most styles of leadership direct their focus first on a mission and second on empowering followers to achieve that mission. Servant leadership directs its focus first on the ability of the individuals to succeed and then on the success of the mission. Servant leaders help their followers to grow and succeed, which in turn aids in accomplishing the organizational mission. The perception of a servant leader should be one of a courageous steward who holds people accountable for their own good. Servant leaders are those individuals who develop and empower others to reach their highest potential. This speaks directly to the individual potential of the followers rather than the organization. Servant leadership assumes that if the followers are maximizing their potential, it will directly translate to the potential of the organization and its overall performance. When servant leadership is applied correctly and with proper intentions, an authentic and natural form of reciprocity takes place between the leader and follower, which in turn increases workforce engagement and improves organizational performance (Gandolfi & Stone, 2018).
Servant leadership includes ten characteristics- listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to growth of people, and building community (Gandolfi & Stone, 2018). Communication begins with listening. A servant leader hears what others are saying through both verbal and nonverbal communication and reflect upon what they hear to lead a group to its full potential. Having empathy or understanding and sharing the feelings of followers allow servant leaders to be placed in a position at the level of those followers. Servant leaders are further able to identify the characteristics hat make each individual unique and provide them with the ability to understand how best to support and lead their followers to achieve success in the mission, in this case how the staff nurses respond to their patients’ needs. While the leaders may not always accept the performance or actions of followers, the leader always accept each follower as an individual.
When the servant nurse leader displays a genuine interest in the team and further support through meeting the needs of the team, the quality of care increases within the organization (Thomas, 2018). Listening and empathy displayed by the servant nurse leader to their patients provides for interprofessional communication as the nurse will include the patient and family to identify the patient needs, make decisions regarding the patient’s care, solve problems together, and evaluate the planned treatment.
As a Nurse Manager, I employed servant leadership especially during the annual employee evaluation process. The employee evaluation process simply stated only evaluates if the individual is meeting the expectations of the organization. It lacks personal development features. I created a format that tasked each nurse to assess areas of strengths and opportunities. Then together we discussed strategies to develop those areas. For example, a nurse with two years of experience felt she was not ‘experienced’ enough to consider growth in the department when viewed alongside nurses with more years of experience. A goal we set together was to attend a preceptor course to then begin first mentoring nursing students and later to precept new hire nurses to the department.
A servant leader is a skilled communicator, a compassionate collaborator, a system thinker, and someone who leads with moral authority. Nursing practice and the vocation of nursing lends itself to the servant leadership model through its dedication of service.
Gandolfi, F., Stone, S. (2018). Leadership, Leadership Styles, and Servant Leadership. Journal of Management Research (09725814), 18(4), 261-269. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=bth&AN=132968632&site=eds-live&scope=site
Thomas, J.S. (2018). Applying servant leadership in practice. Nursing Leadership and Management: Leading and Serving. 1, Ch. 3. Retrieved from https://lc.gcumedia.com/nrs451vn/nursing-leadership-and-mangement-leading-and-serving/v1.1/#/chapter/3
RESPOND TO HERE (150 WORDS, 2 REFERENCES)
Re: Topic 2 DQ 2
The servant leader in nursing is genuinely compassionate and caring towards employees. This type of leader is inclusive and engaging without being coercive toward personnel (Sherman, 2019). The leader shares governance and responsibilities for the unit and organization. The leader seeks to support staff through empowerment and inspiration. The servant-leader assists employees to resolve problems and supports their professional development. According to Sherman (2019), there are characteristics associated with servant leadership including “listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to the growth of people, and building community” (para. 4). These are all qualities that show caring and consideration to others. Many bedside nurses perform exceptionally for their patients utilizing many of these elements up to and including going up the chain of command to advocate for their patients. In nursing, this is a component of the definition of our work. We are tasked within our capacity to assist our patients in achieving healthful outcomes in a caring and empathetic manner that places each patient at the forefront of all care. We utilize limited resources to maximize our performance for the benefit of our patients. Nurses think ahead and foresee potential dangers to our patients. We are persuasive when necessary to attain the help our patients may need. We are interested in the growth and development of our patients through the hospitalization event and onward. We partner with the patient and others to deliver exceptional care. These qualities are utilized for patients who experience an early postoperative complication but are true for the care delivered to all patients.
Sherman, R. (2019). The case for servant leadership. Nurse Leader, 17(2), 86–87.
NURS 514: Organizational Leadership Topic 3 DQ 2
You have been selected to serve on a community outreach committee within your state’s nursing organization. The committee includes registered nurses of different specialties. At your first meeting, it becomes evident that not everyone is in agreement with a recent position statement about the role of spiritual care, with some members arguing they will no longer support the committee if the position statement is not revised or reversed. As a nurse leader, how could you draw from change theory to address these concerns and encourage collaboration on the committee
Re: Topic 5 DQ 1
Preventing workplace violence (WPV) is an issue my organization is very actively involved in and is working to create a healthy work environment. The World Health Organization (WHO) defines WPV, “Incidents where staff is abused, threatened, or assaulted in circumstances related to their work, including commuting to and from work, involving an explicit or implicit challenge to their safety, well-being, or health” (Stephens, 2019). Both physical and psychological harm, including verbal abuse, attacks, bullying, and racial or sexual harassment is considered WPV.
According to a study in the New England Journal of Medicine, four types of violence occur in the workplace, with the second type of violence, that in which the assailant is a customer, patient, or employee of the workplace, is the most prevalent against healthcare workers (Stephens, 2019). A hospital can be a stressful environment and violence is not always criminal. Sick patients may become emotionally volatile. Family members can be stressed and lash out. Psychiatric and behavioral issues are prevalent in our settings, especially the emergency departments. Unfortunately, I have seen confused dementia patients become more aggressive towards staff with interventions that have successfully deescalated other situations.
Neuman Systems Model (NSM) focuses on interactions between patients and their environments and the prevention of negative stressors. Prevention counteracts negative stressors, which reduces a defensive response from the stressor (Casavant, 2020). Betty Neuman’s model can be adapted to many different situations and was based on the patient relationship to stress and reaction to it, making it the best theory to use. Each patient is unique, and a holistic approach and stress prevention is the primary intervention.
The nurse will need to assess for actual or potential patient stressors, lines of defense, and resistance, along with coping factors. Establishing a good interpersonal relationship between the nurse and patient will allow for discussion and goal setting, aligning prevention interventions surrounding patient-perceived stressors. Caregiver self-care is essential and must be accepted and promoted by the healthcare organization. Caregivers that can recognize and identify their stressors are best aligned at prevention for their patients. We should all feel safe at work but more work is needed.
Casavant, S. G. (2020, June 12). At the intersection of science and theory: How the Nurse Role Integration Model reconciles the conflict. International Journal of Nursing Sciences. https://www.sciencedirect.com/science/article/pii/S2352013220300867.
Stephens, W. (2019, May 12). Violence Against Healthcare Workers: A Rising Epidemic. AJMC. https://www.ajmc.com/view/violence-against-healthcare-workers-a-rising-epidemic.